Attention deficit hyperactivity Disorder (ADHD) is a common childhood condition. It is associated with social and emotional problems which often persist through adolescence and adulthood. Stimulants, the most common treatment, have not affected long-term outcome, nor have other treatment modalities, either alone or in combination with medication. Clinical reports by Satterfield and colleagues suggest that multiple interventions may have far reaching short- and long-term effects. The proposed study aims to continue our evaluation of methylphenidate combined with a multimodal treatment consisting of training in social and academic skills, remedial tutoring, school monitoring, parent training, and counselling, and individual psychotherapy. Using a randomized, parallel group design in two study centers (New York and Montreal), the short-term (6-12 months) and long-term (2 years) outcome of ADHD children receiving intensive (weekly) comprehensive intervention for one year and intermittently (monthly) for a second year is being compared to two treatments. The first consists of stimulant medication and professional attention equal in time to the multimodal treatment, but not in the specific content. The second consists of the typical clinical management of ADHD consisting of stimulant medication with management and crisis intervention. We also plan to follow all groups one year after their two years of treatment to examine any differential maintenance effects. It is predicted that multimodal treatment will lead to significantly more improvement in social, academic, and overall functioning, and that the advantages will persist beyond the period of intensive intervention. It is also predicted that compared to controls, a greater percentage of multimodal treated children will be able to be maintained off medication after the first year of treatment.